By Jaelyn Rodriguez

Students getting pricey graduate degrees can get less in federal loans starting next year. Financial aid officials, doctors and policymakers warn it could reshape education, and medical care.

For San Diegans who don’t grow out of their childhood dreams of becoming a doctor, finding the support, mentorship and especially financial help for medical school has made the dream more attainable.

Federal loans have gone a long way for people like Dr. Dimitri Gonzales, a chief resident in family medicine at Family Health Centers of San Diego. Without them, having grown up low-income in Fresno, he says he wouldn’t be where he is today.

Now, months after Congress instituted new limits on federal student loan borrowing by some graduate students, a coalition of doctors, educators, advocates and financial aid officials are bracing for the impacts to patient care, and to aspiring doctors’ dreams.

They’re also warning that the policy will ultimately make the field of medicine less diverse, and discourage medical students from going into lower-paying specialties that already face some of the most severe shortages of doctors.

Last month, some of them joined a roundtable hosted by two San Diego members of Congress, Reps. Scott Peters and Sara Jacobs, to share those concerns.

The new cap on federal student loan borrowing was one of the less-discussed aspects of the contentious Republican spending package passed by Congress on July 4.

Starting July 1, 2026, students pursuing professional degrees, such as medicine or law, can borrow only up to $50,000 per year, with a lifetime cap of $257,000, including undergraduate loans. Graduate PLUS loans — which help students pay for education expenses not covered by other financial aid — will be eliminated entirely.

For the head of financial aid at UC San Diego’s School of Medicine, it’s the most profound and drastic change he’s seen in his career.

“The full cost of attendance, the average, is now over $335,000 — it has gone up,” said John Benefield, the medical school’s executive director of enrollment management and financial aid. “So not just the tuition and fees, but the cost to live — those indirect costs.”

One year of medical school, Benefield said, now costs students around $83,000 all told, including tuition, fees and indirect expenses like food and housing, as the cost of housing rises across San Diego. That makes financial aid even more crucial.

Indeed, over the last five years, the vast majority of UCSD medical students have received financial aid — and on average, their aid packages have well exceeded the new $50,000-per-year cap, data provided by the university shows.

Last school year, 440 of those students, or 77%, were awarded financial aid, and the average total award was nearly $63,000, according to UCSD estimates. And a big chunk of their aid comes in the form of PLUS loans — more than 100 got such loans last year, each with more than $26,000 on average.

“Grad PLUS was really that safety net,” Benefield said. “Now that’s gone for us, it’s a little over $2.8 million just for our medical students that we are going to lose — which means now that the Office of the President is looking for our private loan lenders to really assist our students.”

Dr. Haley Moss, a pediatric resident at Rady Children’s Hospital, graduated from UCSD School of Medicine two years ago.

As a California resident who enjoyed in-state tuition, the school was one of her most affordable options, she said — but still entirely more expensive than the $50,000 cap. And each year of medical school meant adding to her existing student debt from her undergraduate degree and a master’s in public health she already earned.

The new borrowing cap and the elimination of graduate PLUS loans will drastically alter demographics among medical students, doctors, policymakers and aid officials repeatedly noted in last month’s roundtable.

“Underserved students who represent and provide better quality care to underserved populations — such as here in City Heights — aren’t having access to go to medical school,” Gonzales said. “We’re the ones that are taking out the private loans. We’re maxing out those other student loan programs as well. And if we’re not there, our voices aren’t being heard.”

He said there’s serious concern among the group of pre-med undergraduate students he mentors at UCSD.

“They are, like myself, from underserved, underprivileged and low-income backgrounds,” Gonzales said. “For them, even just being an undergrad alone is like a big feat — and it’s still amassing a large amount of debt, because our families can’t afford to pay for our tuition.”

Future medical and law students across the nation are expressing worry about whether they’ll be able to pay for future degrees, and parents are worried about the new limits on PLUS loans, Betsy Mayotte, the president of the Institute of Student Loan Advisors, told The San Diego Union-Tribune in an email.

“Unfortunately, the only other funding options would be private loans,” Mayotte said. “And not all students will qualify for those — at least at reasonable interest rates.”

Private loans also typically don’t offer lower payment options for unaffordable payments, Mayotte added. If there’s a cosigner, their credit can also suffer from late payments, and both the borrower and cosigner risk being sued for non-payment, which could lead to a judgment on their credit report and additional fees, she explained.

“For those that can’t find other funding, I am very concerned about them not being able to complete their degree,” Mayotte said. “So now they have their existing federal loans debt and no degree — which puts them at a high risk of default.”

But the issue transcends individual students’ finances — it impacts the communities students venture into after completing school.

“As a Black woman, there are not a lot of people who look like me in (medicine) — I love getting to fill that role,” Moss said. “I love getting to walk into a room with a Black family and be that care, and be that face.”

But she worries the limits on student borrowing will mean fewer Black students pursuing medicine. Beyond a well-known racial wealth gap, researchers have suggested there are also wide racial disparities in affordable access to higher education.

“There’s a whole lot of Black kids in San Diego that need a doctor that looks like them, and there’s a whole lot of other kids in San Diego that need a doctor who looks like them,” Moss added.

Doctors have repeatedly warned that the cap may also mean fewer of them overall — and worsen an existing shortage, especially in high-demand specialties.

The federal government already estimates that around 19,000 doctors are needed to overcome existing shortages in primary care and mental health care nationwide. And Erin Brennan-Burke, the director of government relations for Family Health Centers of San Diego, says such specialties are expected to be short 35,000 within the decade.

Now, the student-loan changes “could reduce the pipeline of future physicians by making medical school unaffordable for many prospective students, limiting the borrowing and repayment options for physicians in training, and deterring physicians from serving in critically underserved regions,” the American Medical Association said in June.

For San Diego County residents, Peters warns that could spell longer wait times for scheduled appointments, a greater reliance on urgent care and emergency rooms and more preventable illnesses going untreated.

The concern is especially acute for primary care specialties such as pediatrics, family medicine and obstetrics and gynecology, some of the lowest-paid medical specialities. Groups like the American Academy of Pediatrics have warned about the possible impacts on their ranks.

To Moss, it’s another beatdown for an already beaten-down field and discourages students from pursuing it.

“They are looking at their student loan debt and they’re like, ‘There’s no way I can pay that off with the salary that a pediatrician is getting,’” she said. “There are still children in this community that need our help, that need a pediatrician, and they need a pediatrician who looks like them.”

Benefield said that about one-third of UCSD School of Medicine’s graduating class goes into some sort of primary care training. (Many trainees who go into such a residency later sub-specialize.) But he expects fewer students to pursue primary care as a result of the new loan cap.

Still, he cautioned that as of now, the details of the law are still not entirely fleshed out — including the difference between a graduate and professional degree, and who will be affected and how.

“Our current incoming student class will likely be exempt from this, because you get three years after July 1, 2026, three academic years. Again, it’s not defined yet what that means,” he added. “What if they take a leave of absence and they come back? Does that mean that they still get two academic years? We don’t know yet.”

UCSD, like other schools, is still waiting for the bill’s final negotiated ruling to define what these terms are, he said.

In the meantime, medical schools like UCSD’s are already fielding applications from many thousands of aspiring future doctors — many of them worried about how they’ll afford their training.

Those applicants, Benefield said, will be the students most impacted.